Medical Services – Medical Diseases & Conditions

Acute Appendicitis

If you experience symptoms of acute appendicitis, such as sudden abdominal pain, nausea, vomiting, and fever, seek medical attention immediately. Early diagnosis and treatment can help prevent complications and promote a faster recovery.

Digestive system and appendix

What is Appendicitis?

Your appendix is a finger-shaped sac that is attached and opens into the lower end of your colon on the lower right side of the abdomen. See the figure above.

If you experience sudden, sharp, localized pain on the right side of your lower abdomen or sudden pain that starts around your navel and sometimes runs to your lower right abdomen, you may have acute appendicitis.

The pain worsens with movement, walking or being touched, coughing, sneezing or even deep breathing.

In some cases, the pain is associated with nausea, vomiting and low-grade fever that may get worse as the condition progresses.

Visit your doctor immediately if you or your child has these worrisome signs or symptoms. Severe abdominal pain demands prompt medical attention.

Causes and Complications

Causes

An obstruction in the opening of the appendix that leads to infection is the possible cause of appendicitis. The germs multiply quickly, leading to an inflamed, swollen and pus-filled appendix. The appendix can rupture if treatment is delayed.

Complications

Appendicitis can lead to severe complications, like:

  • A ruptured appendix. If a rupture happens, an infection can spread in your abdomen (peritonitis). Potentially life-threatening, this medical emergency demands immediate surgery to remove the appendix and clean the abdominal cavity.
  • A cluster of pus that forms in the abdomen. If the appendix bursts, a cluster of infections can form (abscess). Typically, the surgeon will drain the abscess by positioning a tube by way of the abdominal wall into the abscess. The tube is set in place for two weeks, and you are given antibiotics to get rid of the infection.

Once the infection is clear, appendectomy (surgery to remove the appendix) can proceed. In other cases, the abscess is drained, and the appendix is removed immediately.

Medical Exams & Diagnosis

Your doctor will obtain a history of your signs and symptoms and do an exam of your abdomen to come up with a diagnosis.

Medical exams used to help in the diagnosis of appendicitis are:

An obstruction in the opening of the appendix that leads to infection is the possible cause of appendicitis. The germs multiply quickly, leading to an inflamed, swollen and pus-filled appendix. The appendix can rupture if treatment is delayed.

  • Physical exam. Your doctor will use gentle pressure on the painful area. When the pressure is abruptly released, the pain will feel worse. This tells your doctor that the surrounding peritoneum is inflamed. Your doctor will also check for abdominal muscle stiffness as a reaction to pressure over the inflamed appendix.
  • Your doctor may perform a rectal exam to rule out gynecological problems that could be the source of pain in women of childbearing age.
  • Blood test. A high white blood cell count indicates infection.
  • Urine test. A urinalysis will help rule out possible urinary tract infections or a kidney stone as a source of pain.

Once the infection is clear, appendectomy (surgery to remove the appendix) can proceed. In other cases, the abscess is drained, and the appendix is removed immediately.

Recovery

Expect several weeks of recovery from surgery, especially if your appendix ruptured.

To aid your body in healing:

  • Avoid strenuous activities. After laparoscopic surgery, limit activity for 3-5 days; after open surgery, limit activity for 10-14 days. Consult your doctor for specific restrictions and when you can resume normal activities.
  • When coughing, support your abdomen with a pillow to reduce pain.
  • Begin moving and getting out of bed slowly, gradually increasing activity.
  • If pain medications are ineffective, contact your doctor for further guidance.

Once the infection is clear, appendectomy (surgery to remove the appendix) can proceed. In other cases, the abscess is drained, and the appendix is removed immediately.

Treatment

Treatment for appendicitis generally needs the removal of the inflamed appendix (appendectomy). You will be given antibiotics before surgery to contain the infection.

Appendectomy

Your surgeon will perform appendectomy either as an open surgery or a laparoscopic surgery.

In open surgery, your surgeon will access and remove your appendix by way of a 2-to-4-inch incision on the lower right side of the abdomen.

In laparoscopic surgery, the surgeon can access and remove the appendix with special surgical instruments inserted through small incisions in the abdomen.

Generally, laparoscopic surgery enables your body to heal faster with less pain and scarring. This type of surgery is more suitable for people who are old and obese. However, laparoscopic surgery is not recommended for everyone. If your appendix has ruptured and infection has spread to neighboring structures or an abscess has formed, you will need open surgery to give your surgeon more access to the abdominal cavity which has to be cleaned thoroughly.

You may stay one or two days in the hospital after your appendectomy.

If the appendix has burst and an abscess has developed around it, the abscess can be drained by positioning a tube through your skin into the abscess. An appendectomy may be conducted a few weeks later after managing the infection.

If you have any questions, or would like to schedule an appointment, please email or contact us now.

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